Introduction: The contralateral ear in patients with cholesteatoma is seldom studied, although it has a great risk of also developing a cholesteatoma. Objective: To evaluate a possible relation between the cholesteatoma ear and the contralateral ear. Methods: The authors examined the files of 51 patients suffering from cholesteatoma and correlate the otoscopic findings of the contralateral ear with the presence of nasal disease, function of Eustachian tube and pneumatization of the mastoid air cells. Results: There was a retraction pocket in 30% of the cases and a cholesteatoma in 10% of the contralateral ears. Conclusions: The systematic examination of the contralateral ear is of utmost importance due to the numerous anomalies found.